Orlistat inhibits the absorption of fat-soluble vitamins like vitamins A, D, E and K. It is recommended that patients take a multivitamin in addition to orlistat to ensure adequate intake of fat-soluble vitamins. Orlistat may also decrease the serum concentrations of certain medications, so doses should be separated. Patients taking orlistat should be monitored for signs of low blood sugar if they have diabetes. Orlistat is contraindicated for pregnant women, those with malabsorption issues, or known hypersensitivity to orlistat.

1. Pay attention if you are taking orlistat
Owing to orlistat ’ s mechanism of action, a decrease in the
absorption of fat-soluble vitamins (vitamin A, D, E, and K) has been
noted. This occurs because orlistat inhibits the lipase that breaks
down fat-soluble vitamins into absorbable components. It is
recommended that the patient take a multivitamin containing
fat-soluble vitamins in order to ensure adequate intake.
Multivitamin administration should be separated from orlistat by at
least 2 hours or should occur at bedtime. Orlistat was found to
decrease serum concentrations of amiodarone, cyclosporine,
levothyroxine, and antiepileptic medications. It is recommended to
separate doses of orlistat from cyclosporine by 3 hours and from
levothyroxine by 4 hours. Patients who are taking antiepileptic
medications concurrently should be monitored closely for any
changes in frequency or severity of convulsions. Because of
decreased vitamin K absorption, warfarin concentrations may also
be affected, resulting in an increased international normalized ratio;
patients should be monitored closely when this vitamin is taken
with orlistat. It is also important to tell patients with diabetes who
are taking orlistat that weight loss may increase the risk of lower
blood sugar and that they should watch for signs of low blood sugar,
such as dizziness, headache, feeling weak or shaky, sweatiness, or a

2. fast heartbeat. Orlistat is contraindicated in patients who are
pregnant, have chronic malabsorption syndrome or cholestasis, or
have known orlistat hypersensitivity.
It is also important to tell patients with diabetes who are taking
orlistat that weight loss may increase the risk of lower blood sugar
and that they should watch for signs of low blood sugar, such as
dizziness, headache, feeling weak or shaky, sweatiness, or a fast
heartbeat. Orlistat is contraindicated in patients who are pregnant,
have chronic malabsorption syndrome or cholestasis, or have
known orlistat hypersensitivity.
Reference
1."Orlistat: theoretical interaction with antiretroviral HIV medicines".
MHRA. 13 March 2014. Retrieved 16 November 2014.
2. PDB: 2PX6​ ; Pemble CW, Johnson LC, Kridel SJ, Lowther WT
(August 2007). "Crystal structure of the thioesterase domain of human
fatty acid synthase inhibited by Orlistat". Nat. Struct. Mol. Biol. 14 (8):
704–9. doi:10.1038/nsmb1265. PMID 17618296. S2CID 2105534.
3. Heck, A. M.; Yanovski, J. A.; Calis, K. A. (March 2000). "Orlistat, a
new lipase inhibitor for the management of obesity". Pharmacotherapy.
20 (3): 270–279. doi:10.1592/phco.20.4.270.34882. ISSN 0277-0008.

3. PMC 6145169. PMID 10730683.
4. Higham, George. "ᐅ Orlistat & Xenical: Do Weight Loss Pills Work?
| e-Surgery". e-surgery. Retrieved 9 June 2020.
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